AK Notes Flashcards
Five responsibilities of a facilitator
- starting and ending the meeting on time
- Controlling topics
3 preventing negativity - Prioritizing topic
- Prevent team member from dominating the meeting
What does Smart stand for
Specific, measurable, agreed, realistic, time bound
List four r’s of Team Management
1 Responsibility,
2 respect,
3 rapport,
4 recognition
Define five potential employee scheduling options
1 Rotating schedule - staff, duties and shifts rotate;
2 hybrid schedule- a mix of fixed and variable days;
3 skill-based- based on the known skill set;
4 split scheduling - when an employee works for more than one business unit within a work day. Example - 8a-2p with surgery then 3p-7p to ER;
5 per diem - scheduled one day at a time as needed by the practice
When it comes to staff scheduling _______ is one of the most desired employee benefits
Flexibility
An unusual number of clients arriving early or late to the appointment maybe a sign of what?
An ongoing appointment scheduling and time management problem at your hospital
Name five of the nine details to consider regarding appointment scheduling criteria for making appointment schedules
- number of doctors available during any particular period
- the relative efficiency of the doctors.
- Time allotted to each appointment
- The number of patients presented by each client
- Types of cases seen
- Number of exam rooms
- Hours of Hospital operation, including the hours for scheduled and non-scheduled activities
- favored client times for veterinary care
- Vet tech appointments
Three ways to avoid appointment problems with clients
- Appointment cards if clients make appointments while in the clinic
2 proper Hospital protocols that prepare the team for unexpected challenges
3 Advanced reminders within 24 hours of the appointment is considered best practice
Break down the three 5 minute sections for a 15 minute annual wellness exam
- The first five-tech check-in for history and vitals
- The next five- Doctor is present for physical exam, answers questions, gathers information, discuss preventive care
- The last five- collect lab samples, fill prescriptions or vaccinate
An effective appointment system should have what two goals
- To eliminate client wait time
- To maximize the efficiency of the doctors the support staff and the facility by minimizing downtime between clients or patient procedures
In the 70/20/10 Learning and Development model; Define the elements involved
- 70% of learning within an organization should come from on the job training
- 20% from coaching and mentoring
- 10% from actual courses, lectures and formal training
List and Define the three main ingredients of a professional development plan
- Training - an ongoing process that focuses on the employee’s current job and it’s related knowledge, skills, and abilities
- Development - focuses on skills, knowledge and abilities that are not necessarily focused on their current job
- Career management- serving as a career coach for employees and supporting them through the employment cycle
Why are core competencies important in staff development
Because they can be tiered to beginner, intermediate and expert or because they can be considered in terms of reward based compensation
The _____ and _____ of the practice help to find the core competencies that should be expected of employees
Mission and values
Customer relation management
A productive process of gathering data about client preferences and activities to better Target their services and products to client needs
General skills managers need to possess to effectively handle the dilemmas in a vet practice
Human, technical, conceptual
Accounting equation
Assets + liabilities + equity
Annual revenue per veterinarian
Annual gross Revenue/ number of FTE veterinarians
Average transaction value
Total revenue/ total number of transactions
Average inventory on hand
(BI + EI) / 2
Inventory turnover ratio
DMSP ( total purchases during the year) / AI
Annual purchase of supplies/Avg Inventory value
4-8 or 8-10 turns per year equals good
AI = (BI + EI) / 2
Full absorption pricing method
Includes overhead cost
Using 45% estimate
OHC = 0.45 X SP
SP = FC + OHC + P
Variable cost (inventory)
Must take into account things like how DVM is compensated
Add desired profit margin to variable cost
Sales price
SP = FC + VC + P
SP - sales price
FC - fixed cost
VC - variable cost
P - profit
Inventory turnover ratio
Dmsp/ AI = inventory turnover ratio
Average inventory on hand
( BI + EI) / 2 = AI
Bi- beginning inventory
Ei- ending inventory
Calculating inventory turns
Inventory turnover ratio
Total annual purchases divided by the average inventory value on hand
Value of drugs and medical supplies on hand at the beginning of the year at cost (BI)
Value of drugs and medical supplies on hand at the end of the year at cost (EI)
Some total of drug and medical supplies purchase( in dollar) made over the course of that year (DMSP)
Regarding evaluating Medical insurance plans; name at least four ingredients that should be included when creating a checklist to Aid and evaluation
Type of plan (ppo, HMO, pos)
Details of coverage
Size of the providers and related services and Facilities within the network
Cost
Employee eligibility
Simplicity of administration
4 documents found in an employee medical file
Health and Life Insurance forms,
physician notes,
insurance or workers comp claims,
physical exam results,
FMLA Docs
What personnel file should be stored away in a separate file?
I-9
Name at least five documents that should be in a personnel file
- Application, resume, interview notes, background checks. 2. job description.
- offer of employment letter.
- performance evaluation, education training.
- disciplinary documents.
- emergency contact info.
- W2. Number
8 degree, diploma, certificates.
9 contracts.
10 employee action forms.
11 leave of absence and attendance records
What common vet employee benefit documents the IRS require be reported as taxable, and what percentage is the cutoff for not reporting?
Pet Health discount policy that discounts services at greater than 20%
All discounts after 20% need to be reported as taxable
What element of a job description can help you avoid hiring someone who is unable to perform essential duties of the position?
Listing what is considered an impediment to satisfactory performance such as being afraid of aggressive pets
What specifics should be included in the accountability section of a job description?
A. Where does this position reside in the hierarchy of the practice?
B. Who do they report to?
C. Who evaluates performance?
D. How much Authority does this position have
Average turnover time per year
Companion Animal = six times per year
Full absorption pricing method
Includes overhead cost (OHC)
*using 45% estimate
OHC = 0.45 X SP
SP = FC + OHC + P
Inventory turnover ratio
4 to 8 or 8 to 10 turns per year = good
DMSP ( total purchases during the year) / AI
AI =(B1 + E1)/2
Exp: BI = 3000; EI = 2500
Total purchase = 26,000
AI = 2750
Inv turnover = 9.5
Economic order quantity (EOQ)
EOQ = (2 × A × F) / (H × UC)
A = Annual demand in units
F = fixed ordering cost incurred per order
H = holding cost expressed on an annual basis as a percentage of unit cost
UC = unit cost to purchase from vendor or supplier
What three purposes do Hospital manuals serve?
- A reference to for SOC and practice guidelines
- Training and instructional tool
- They defined a standard to which the employee can be held accountable
What is the most common bacteria present in a dog and cat bites?
Pasteurella
Four priorities of General Emergency Management
- Mitigation- strategies and actions that reduce the likelihood and impact of a threat
- Preparation- planning and training action steps that develop the capacity to respond to threats
- Response - Actions taken in the face of an emergency situation
- Recovery - the process of returning to normal after an emergency event lengthy
Organizational design
A relationship centered practice is defined As utilizing empowered veterinary team members who share knowledge to develop long lasting or relationships with clients and patients period which elements of strategic planning best addresses this dynamic?
Lack of follow through from management Push form of learning versus pull And negative peer pressure from team members who have Plateaued, are all common reasons for what Question mark
Resistance to learning
Which phase of strategic planning includes the development of the mission comma vision and values and why are they so important?
The formulation phase. The mvv’s are critical because the represent the goals of the organization and every decision made for the business, employees, clients or patients must support the goals and therefore the mvv’s
Zoonotic Host
The living organism that provides the environment for the maintenance of the organism but may not be necessary for the organisms survival
Risk assessment equation
Hazards + vulnerabilities = risk
Five strategies to reducing malpractice
One. CE
2. Thorough medical records
3. Practicing informed consent
4. Staff training
5. Referrals
Once a vcpr is established treatment must continue until
A the animal recovers; B the practitioner has agreed to all the treatment that was agreed upon; c the animal dies; d the client terminates the vcpr; e. The responsibility for treatment is transferred to another practitioner with the consent of the client
Two steps for pregnant women around gases
One. Anesthetic monitoring badge; 2. Proper PPE
Three types of gas scavenger systems
1.active scavenger( the best)
2. Passive
3. Absorption
When treating a patient with chemo, why is it critical to have detailed and thorough communication with the client?
Some chemo agents are eliminated in the urine and feces of the pet and can potentially expose family members
Zoonotic reservior
A place where an infectious organism survives or replicates
To get the most efficiency from a CPA at tax time, it is best to have obtained their services, for tax planning prior to the end of the calendar year and to have all accounting records to the CPA by
The third or last week of January
What separates CPAs From bookkeepers or accountants
A CPA is a college-trained accounting professional who has attained certification via a comprehensive exam, and maintains the certification with continuous continuing education
The role of liaison for practice manager involves more than relationships with vendors what are some examples
The role of liaison is a full-time responsibility involving staff, vendors, authorities, professional peers and advisors, independent contractors, clients, practice owners, or stockholders, consultants and any other relationship involving the practice
Why is it recommended to have a study and ongoing relationship with an attorney
The strategy avoids the Urgent and crisis oriented circumstances and maintains more of a preventative relationship for the practice
True or false, in reference to disease transmission please ticks and mosquitoes are considered vectors
True
How can you calculate the average age of the accounts receivable entries
Beginning AR plus ending AR / 2 = average accounts receivable
Regarding the value of accounts receivable turnover Semicolon Is it better to have a higher or lower number
A higher value for the ratio is better because it indicates the accounts receivable balance is turned into Cash more often
Accounts receivable turnover is how many times the accounts receivable balance is converted into Cash. What is the AR turnover formula?
Credit sales / average accounts receivable = accounts receivable turnover
Which act regulates collections procedures of past due accounts
Four debt collection practices Act
When a non-sufficient funds check has been written to the practice, the practice has three choices of actions what are they?
A. Except the financial loss; B. attempt to collect, c. Use a third party collection agency
If the practice is found to be spending more than it’s generating, what steps can be taken to gain control?
A decrease spending and increase Revenue; b. Hold employees accountable for waste; c. Consider reevaluate your fee structure; d. Review charges to be sure that they are being captured correctly and not missed; e. If a line of credit is needed to keep the practice viable in the short term, have a plan to pay back the loan as soon as possible
At the end of the year, any independent contractor who received more than $_____ and wages from the practice must be issued at 1099 form
600
Regarding payroll deductions; what does FICA stand for? What does it fund? And is it paid for by the employer, employee or both?
Federal insurance contribution Act; a tax paid by both the employer and the employee to fund Social Security and Medicare
The basic accounting equation is
Assets = liability + owner equity
When compounding expenses on the profit and loss statement it is important to express expenses and dollar amounts and..
A percentage of gross
What is another name for the profit and loss statement
The income statement
Which type of accounting is typically considered more accurate
Accrual
This type of accounting recognizes Revenue when it is earned and expenses when they are incurred when goods are received and services are performed
Accrual
Define cost of goods sold
The products used to produce a service for the client or products sold to clients
Our wages for doctors who are paid on a salary basis considered a fixed or variable expense
Fixed
What three financial responsibilities are typically outsourced in most practices
A. Primary tax preparation and advice
B. valuation of the practice
C. Large Financial issues
A practice without conflicts could indicate what type of practice dynamic and what are potential negative side effects of those Dynamics
A. Staff members may be afraid to speak up. The practice culture is where team members are trained to do what they are told. The team thinks so much alike that there is little creativity to promote Innovation and change
B. This type of environment can Sap the teams Enthusiasm and initiative. it can also encourage passive resistance because open conflict and difference of opinion isn’t tolerated
What are potential risk of delaying a conversation once an issue is known
A. May result in additional conflict
B. Maybe interpreted that management is not interested in the problem
What are the four steps and successful intervention regarding conflict management
- confront the behavior
- Talk it out
- Hold team members accountable for solutions
- Follow up and feedback
What are the four steps and successful intervention regarding conflict management
- confront the behavior
- Talk it out
- Hold team members accountable for solutions
- Follow up and feedback
Define at will employment
A form of employment in which the employee is servicing the employer at the will of both parties this allows the employer to terminate its employees with or without cause
Define the ideal witness to a termination
The same gender and in a supervisor position, not a direct peer of the employee being terminated
What is the suggested protocol for an employee who is performing poorly due to a short-term personal life stressor
They should be advised that it is unsatisfactory and that if not for these problems they would be terminated, but will be given the opportunity to improve once the short-term problems are resolved. Reevaluate at that time
Name 4 Express exceptions to at will employment
- Collective bargaining agreements; 2 contracts that indicate a length of employment;
3 race, sex, color, origin, religion;
4 pregnancy;
5 over 40 years old;
6 a workplace the employee considers unsafe;
7 bankruptcy;
8 jury duty
Civil Rights Act title VII
Termination based on race, sex, color, natural origin or religion
Pregnancy Discrimination Act
Termination based on pregnancy
Age Discrimination Act
Dismissal over 40
OSHA
Dismissal because of an employee refuses to work in a workplace they consider unsafe
Bankruptcy Reform Act
Dismissal due to bankruptcy
Which plan enables employees to make their medical insurance premium payment before taxes are deducted from their paycheck and can also mean substantial pre-tax savings for employers
Section 125 plans
What six factors are generally considered by the courts and applying for economic realities test under the flsa
-the degree of control exercised by the practice over the individual work performance
- the extent of the relative Investments by the practice and the individual and equipment and supplies used
The individuals opportunity for profit and loss through managerial skills
The skill and initiative required by the work
The permanence of the relationship
The extent to which the workers services are an integral part of the practice
Section 125 plan
Enables employees to make their medical insurance premium payment before taxes are deducted
Law of negligence - 4 elements
1 - establishing that the defendant had a duty to prevent an injury
2- Establish defendant violated that duty by failing SOL
3- Show close casual connection existed
4- Proving that damage or harm occurred
gross profit margin
difference between the cost of a product and the revenue it generates
Net profit margin
end of year revenue (=2400000)
profit was (=312000)
profit margin % = (312000 / 2400000= 13%)
days cash balance
practice has 94,250 in cash, annual operating expense =1,677,000
cash/annual operating exp/260 days
94,250/ (1677000/260) = 94250 / 6450 = 14.6
Ideal to have 20-30 days of cash
Common sizing
revenue = 3691000
expenses = 2952800
2952800 / 6391000 = 80%
expenses = 80%; profit= 20%
20-30% is prefereable
Breakeven investment
Laser cost = 35000
cost per use = 18.00
client charge = 85.00
35000/85=412 sessions = 100 weeks to break even
85-18=67
35000/67=522 sessions = 130 weeks
Accts receivable turnover
credit sales/avg AR = AR turnover
credit extended = 43426.98
Avg AR = 16036.62
43426.98/15036.62 = 2.9
Accts receivable turnover
Jan 1 = 22968.75
Dec 31 = 7104.50
A=BAR +EAR/2=
30073.25/2=15036.62
Annual Revenue/Accts Receivable
CRAFT
Compliance = Recommendation + Acceptance +Follow through
Most important factor in 20-factor common law test
the right to control and direct work
Single most effective method of marketing service to a client
assumptive sale technique
ancillary benefit of ration based inventory system
Duplication is minimized
Diminished amount of obsolete items
products are easier to find
price changes can be accommodated more easily
5 steps to culture changed
1 Define culture
2 Align behaviors with desired culture
3 Commit to the change
4 Support the shift
5 Grow the team
two steps in additional staff hiring
Develop a budget
Create a job description
Customer relation management
proactive process of gathering data about client preferences and activities to better target products and services relevant to their needs
Customer experience Management
A process of creating an experience that is positive and memorable
Individual development plans are created by:
The employee with input of their managers
Training technique that yields a high success rate:
Role playing
4 steps of drug intervention
-Time the intervention for when the addict is not impaired
-Be specific
-State the consequences
-Listen
3 Characteristics of offering retail goods
Image
Space
Vision
6 steps of budgeting
1 Determine the desired results
2 Analysis of financial statements
3 normalize the revenue and expenses
4 budgeting revenue
5 budgeting expenses
6 combine budgeted revenue and expense and making adjustments
*not comparison of the last 3 yr expense as a % of gross
AR should be no higher than ____% of gross revenue
1.5%
Fixed cost (inventory)
range 15-35%
Holding cost
8-15% of inventory expense
Avg shelf life in days (ASLD)
Divide # of days in the period being measured by the Inventory turnover ratio (ITR) for the correlating period
365(year) / Annual ITR = ASLD
Proceeds from a note
Face value + Interest - original price
(5000 * 12% * 60/360) = 100
5000-100=4900
Economic Order Quantity (EOQ)
Sq root of (2AF)/(H*UC)
A=Annual demand in units
F=fixed ordering cost/order
H=Holding cost expressed on annual basis as % of unit cost
UC=cost to purchase from vendor
AI
Inventory Turnover
Avg Shelf Life
BI=3000 EI=2500 Purchase=26,000
AI=3000+2500/2=2750
Inv Turnover=26,000/2750=9.5
Avg Shelf life=365/9.5=38
Gross margin problem
wholesale cost: 14.75
retail cost: 26.50
Gross margin in $ and % = $11.75 44%
11.75/26.50=44%
26.50-14.75=11.75
Gross markup = 26.50-14.75 14.75=79%
Efficiency ratio
- # of patient visits / # of staff hours
employee rention
- (# of positions retained / # of positions in the organization) * 100
Employee turnover
- (# of employees who have left / # of employees who are in the organization) * 100
Equity Ratio
total liabilities/total owners equity
contribution margin ratio
(sales - variable cost) / sales
inventory turnover
annual purchase of supplies/average inventory value
- # of days in a period/turnover rate
Net income before taxes
gross profit - operating expenses = net income
Net income or loss
net income - taxes = net income or loss
Profit margin
net income (before taxes)/ revenue
Profitability ratio
operating income/ revenue
return on investment
(expected annual return/investment) * 100
Working capital
cash on hand + A/R - current liabilities
A/R turnover
annual revenue/accounts receivable
Average age of A/R
365/A/R turnover
Average age of inventory
365 days/year / inventory turnover ratio
Cash flow (current ratio)
current assets / current liabilities
FICA is paid by
employer and employee
FMLA is enforced by
US Department of Labor
Stockholders equity is increased by
net income, stock issuance, capital contributions
Which focus areas should be included in the written standards of care for internal hospital image
merchandising, sterility, cleanliness, function
Gross profit
revenue - cost of goods sold = gross profit
Declining balance (twice straight line)
$9000 Dental unit
$300 residual value
3 yrs life
1st yr - 9000 * 2/3 = 6000
2nd yr - 3000 * 2/3 = 2000
“An employee development system based on mutual commitment between practice leadership and its staff members” describes what positive employee training tool?
Employee performance planning program
List 3 most common reasons staff members leave
1 lack of positive feedback
2 lack of training opportunities
3 failure of management to include them in the larger strategic vision of practice
new employees must have immediate knowledge of what 5 safety details
1 location of the first aid, eye wash, exits
2 location of all PPE and instructions on use
3 location of all mandatory posters
4 location of all the hospital safety manual
5 copies of all applicable OSHA standards
What is a reasonable budget to spend on training annually?
1-2% of annual revenue of the practice
What are phase training list and what are four benefits of using them
Outlines the progressive steps in the training for a specific position within the practice
1 Helps insure team members are trained properly
2 Aids in titrating info/instruction to the employee to avoid overlooking them early in the process
3 provides a resource for training preparation for the trainer
4 provides reference and review material for the new employee
Information revealed in the background checks can be helpful with hiring decisions and should be conducted on all candidates who make it to the final hiring pool. T/F
False - Background checks should only be made after a contingent employment offer has been made
Define bona fide
occupational qualification
To establish a defense of bona fide occupational qualification the employer has the burden of proving that a particular class of employees would be able to perform the job safely or efficiently and that the bona fide occupational qualification is reasonably necessary to the operation of the business.
List 4 phases in the employee life cycle
1 acquisition
2 orientation and training
3 performance and feedback evaluation
4 leave the practice
List the 4 elements necessary to hold working interviews
1 must be on payroll
2 must be eligible to work in the US
3 must be paid at least minimum wage
4 must be covered under workers comp
What are the federal retention laws for applicant documents such as resumes and employment applications
One year from filling the position unless you suspect the applicant is over 40 years of age, then it is recommended that to keep records for 2 years
Ultimately the __________ is responsible for the efficiency, function and flow of the practice.
Manager
It is vital that staff meetings stay on track, and ______ can help facilitate this
Agendas
List five of the seven ways to engage employees during a staff meeting
1 Using visual aids
2 Tasteful appropriate humor
3 Publicly praise work well done and celebrate successes
4 Do not allow meeting to turn into gripe sessions
5 Share important information, changes and progress towards goals so that people want to be at the meeting and not miss out on the announcements
6 Request/require team members to present topics
7 Learning games or ice breaker exercises.
What details should be included in meeting minutes?
1 Record decisions and assignments
2 Designate responsible parties
3 Record the deadline agreed upon during the meeting
4 Who was present
5 What topics, if any, will be revisited at the next meeting?
What is the best way to end a staff meeting?
On a positive note
List 4 of the 6 elements that should be included in an employee performance review
1 Conversation about mission, vision and values of the practice
2 clarity about goals and direction
3 addressing team members accomplishments
4 address concerns over policy and procedures
5 address potential conflict with team members or management
6 Address any lapses in standards or judgment (many times these conversations should happen in the moment and not wait for a performance review)
Employee performance reviews should be developed from the ________ _________
Job description
What renders an employee performance review useless?
Lack of clear performance expectations in the job description because without them team members cannot be held accountable
What are the 3 most common types of employee performance reviews
1 360 Peer Review
2 Self-review
3 Job satisfaction survey
What are 4 disciplines necessary for an effective employee review?
1 Hold all employees accountable for their local performance outcomes
2 Teach all employees to identify, deploy and develop their strengths
3 Align all performance appraisals and review systems around identifying, deploying and developing employee strengths.
4 Design and build each role to create world class performers in the role
The most successful employee performance review programs typically combine what 4 elements?
1 regular informal feedback from supervisor
2 performance goals that are set by the employee and the supervisor
3 Action plans to address performance or disciplinary problems
4 Formal reviews that document the “Big Picture”
List 5 of the 9 potential pitfalls regarding employee reviews
1 Spending more time on performance review than performance planning, more time should be spent on preventing performance problems
2 Be careful comparing employees
3 Forgetting the review is about performance not blame
4 Stopping reviews when pay is no longer tied to the review
5 Believing the manager is in a position to accurately assess team members
6 Cancelling or posting review
7 Measuring the trivial
8 Surprising a team member during the review
9 Thinking all employees and all jobs should be assessed the same way
Job descriptions are required by federal law
t/f
False
How often should job descriptions be evaluated for accuracy, and what changes to the practice might indicate and update is necessary?
Job descriptions should be evaluated for accuracy annually (more often in the case of staff reduction or growth)
Explain the difference between the Hospital Operations and Procedure Manual and the Employee Policies, Procedures and Guidelines Manual
A hospital operations and procedure manual is a comprehensive text that details every aspect of specifically how you want work to be done. An Employee Policies, Procedures and Guidelines Manual details clarity and purpose to the practice mission and values, and also details expectations, compensation & benefits, legal disclaimers and other details surrounding employee specific policy and procedures.
Avoidance of the the other person(s), personal attacks, hurtful gossip, barbed humor and lack of cooperation are all potential symptoms of what dynamic within your practice?
a. vague guidelines/policies regarding conflict resolution
b. symptoms of conflict with in the practice
c. lack of accountability and leadership
b. symptoms of conflict with in the practice
What are the top 3 that cause conflict in the workplace environment?
Gossip, lack of training and lack of communication
Which plans are a blend of Fee For Service and HMO medical plans. They do not require a visit to a primary care provider prior to visiting a specialist, although they do have a network of preferred providers and it is more costly to go outside that network
a. point of service plan
b. managed care plan
c. preferred provider organization plan
c. preferred provider organization plan
What addition to medical insurance is owned by the employer?
Flexible spending plan
The patient protection and affordable care act requires employers with ______ or more employees to provide group medical insurance or receive a penalty.
50 full time employees
Why are employee medical documents stored separately from their main personnel file?
a. While it is sometimes appropriate or necessary for a direct supervisor to see some personnel records, there is rarely a reason for them to see medical records.
b. The ADA and FMLA require that medical records be stored separately.
c. both A & B
d. neither A or B
c. both A & B
Employee wage garnishment orders and credit reports are to be filed:
a with the payroll records
b. with the main employee records
c. either location is acceptable.
d. neither is acceptable
c. either location is acceptable
Which entity or entities require employers to keep detailed payroll and benefits data? Access should be limited and ideally stored separately
a. The internal revenue code
b. fair labor standards act
c. equal employment opportunity commission
d. all the above
a. The internal revenue code
b. fair labor standards act
At the core of any safety plan or manual is the ___________ law.
Right to know
A section on chemotherapy should be included in every veterinary health and safety manual regardless of wither or not that practice performs chemotherapy.
t/f
True
One way to begin to create an Operations and Procedures Manual is to refer to the ________ of the practice.
a. job descriptions
b. tasks check list
c. health safety manual
Job descriptions
A controlled drug with a high potential for abuse and severe dependence, but does have currently accepted medical uses in the United States, would be in what schedule of narcotics?
Scheduled II
A non-veterinary staff member may prescribe any non-controlled drugs if directed to do so by a licensed veterinarian who employs them, and if that veterinarian directly supervises the staff member.
t/f
False - non veterinary staff members may not prescribe any drug
Under what 4 conditions will many states allow a non-veterinary staff member to administer controlled drugs?
- If they are agents or employees of the registered practitioner.
- They are preforming the task in the usual course of business
- They are acting under the direction of a licensed veterinarian
- They are under the direct supervision of a licensed veterinarian.
What is the process for lending a fellow veterinary a Scheduled II drug?
Must use the DEA 222 form, Copy 3 of the form stays with the veterinarian who received the drug, Copy 1 stays with the registered practitioner supplying the drug. Copy 2 is sent to the DEA
Regarding the DEA form 222, what is the correct destination for each of the 3 copies of the form?
- Copies 1 and 2 of the DEA 222 must be submitted to the supplier
- Copy 3 of the form is retained by the registrant.
- The supplier retains copy 1 and sends copy 2 to the DEA.
List 2 steps to take when a controlled drug has been lost or stolen.
- Registrants are required to notify the regional office of the DEA using a DEAH form 106
- The local police department should also be notified.
Define Adulterated Drugs
Drugs that contain unsanitary components, lack of adequate control in manufacture, differ in strength from official compendium or that are mixed with another substance. Example: a practitioner takes two or more FDA-approved drugs and mix them in one syringe or bottle. In doing this the drugs have been adulterated and administering such a drug is a violation of the FD&C act.
List the 5 label requirements for prescription drugs
- The statement “Caution: Federal law restricts this drug to use by or on the order of a licensed veterinarian
- Recommended dose and route of administration
- Quantity or proportion of each active ingredient
- Names of all inactive ingredients if drug is for non-oral use
- Identifying lot or control number for which it is possible to determine the complete manufacturing history of the drug.
In regards to an OSHA inspection; employers have the right to deny access to specific areas of the building to avoid disturbing the business process.
t/f
False - Employers have the right to require a warrant, or to request a postponement but not deny access once the inspection/investigation has begun
A veterinary acupuncturist leases space from a general practice. Does the general practice need to share the hazard assessments form their department, even if the acupuncturist works in a separate part of the building?
Y/N
Yes - All separate businesses within a shared space must create a hazard assessment for the entire area.
What else might the entities above be required to share or address?
(A veterinary acupuncturist leases space from a general practice. Does the general practice need to share the hazard assessments form their department, even if the acupuncturist works in a separate part of the building? - Yes)
Each separate entity within the hospital will need to provide the other entity with their Safety Data Sheets, or store the safety information in a central location
What 5 elements must be in a Hazard Chemical Plan
- Must be in writing
- A complete list of all hazardous chemicals must be maintained.
- Safety Data Sheets library
- All containers properly labeled
- Staff training
Descriptive Ethics
Refers to the study of ethical views of veterinarians and veterinary professionals regarding their behavior and attitudes. Essentially what is right and wrong
Official Ethics
Involve the creation of the official ethical standards adopted by professional organizations and imposed on its members
Administrative Ethics
Involves actions by administrative government body that regulate veterinary practice and activities in which veterinarians engage. License revocation can result if any civil or criminal violations of these regulations occur
Normative Ethics
Refer to the search for correct principles of good and bad, right and wrong and justice and injustice
What is the veterinary practice act?
A state’s or commonwealth’s law, codified into regulations, describing what licensed and non licensed employees can and cannot do, as well as acceptable medical standards, as it relates to veterinary medicine.
What is involved in making changes to the Veterinary Practice Act?
Proposed changes must be submitted to the House and Senate and ultimate signed into law by the Governor
What 6 elements do the courts want satisfied to consider the existence informed consent in a situation?
- Consent must be given freely
- Treatment and diagnosis must be given in understandable terms
- The risks, benefits and the prognosis of the defined procedure must be stated.
- The prognosis if no treatment is selected must be stated.
- Practice must provide alternative treatments, including risks, benefits and cost.
- The client must be given an opportunity to ask questions and have them answered.
The law of _________ ___________ was created to avoid benefit of one party at the expense of another (owner receives emergency veterinary care at the veterinarians expense)
Unjust enrichment
In relation to the Acceptance stage of a contract; what is the difference between Express Acceptance and Implied Acceptance?
Express Acceptance - a clear statement of agreement to the terms offered that establishes an Express Contract
Implied Acceptance - no direct statement of agreement, but is demonstrated by actions indicating acceptance f the offer leading to an Impacted Contract
Although there may have been no formal agreement, justice requires the enforcement of one’s promise when another party has justifiably relied on that promise, changed its position, and incurred substantial detriment. This situation is called ________ ________
Promissory Estoppel
When it comes to the Law of Agency; what two scenarios are considered likely to be common in veterinary medicine?
1 Agency and Consents for Care
- Agency and Consents for Euthanansia
When lending a controlled drug to another practitioner, what step is unnecessary for schedule III, IV and V drugs, that is not necessary for the schedule II drugs?
a. Using the DEA 222 from. Copy 3 of the form stays with the veterinarian who received the drug. Copy 1 stays with the registered practitioner supplying the drug. Copy 2 is sent to the DEA.
b. It is illegal to lend a schedule II drug
c. Using the DEA 222 form, although both the receiving DVM and supplying DVM should log copies, no copies needs to be sent to the DEA.
a. Using the DEA 222 from. Copy 3 of the form stays with the veterinarian who received the drug. Copy 1 stays with the registered practitioner supplying the drug. Copy 2 is sent to the DEA.
Regarding veterinarians who work at more than one location; they may administer, dispense and prescribe controlled drugs providing they have a current DEA registration at central place of business.
t/f
False
Under what circumstances can a DVM dispense an adulterated drug?
a. When all ingredients are FDA/CVM approved
b. Under no circumstances
c. As long as there are no more than two drug combined and both are FDA/CVM approved.
b. Under no circumstances
The AVMA Principles of Veterinary Medical Ethics is an example of what branch of ethics?
a. Descriptive
b. Official
c. Administrative
d. Normative
b. Official
In regards to Unjust Enrichment - the legal system will look for which of the following elements before considering applying the law to a situation:
a. The more emergent the animal’s needs are the more leeway exist to provide the emergency medical care.
b. The veterinarian attempted to reach the owner prior to medical care.
c. The extent of the emergency care required to stabilize the patient was reasonable.
a. The more emergent the animal’s needs are the more leeway exist to provide the emergency medical care.
b. The veterinarian attempted to reach the owner prior to medical care.
c. The extent of the emergency care required to stabilize the patient was reasonable.
A clear statement of agreement to the terms offered is called a what?
a. expressed acceptance
b. implied acceptance
a. expressed acceptance
In a Covenant not to Complete the scope of activity is generally restricted and includes a time limitation and geographic restraint.
t/f
True
What laws involve a person who has been authorized to act on behalf of another?
a. Law of Authority
b. Law of Agency
c. Law of Power of Attorney
b. Law of Agency
What are the three main details the FLSA was created to address?
1 Establish a minimum wage
2. Define overtime pay standards
3. Regulate the employment of minors
Can the owner of the practice, be held responsible for the discriminating actions or behaviors of their employee towards another employee?
Yes
Manger Jane Doe is relieved that her small practice of 18 employees is too small to be required to follow make accommodations under the ADA. Should she be relieved? If so, why? If not why?
No she shouldn’t be relieved, any employer with 15 or more employees is required to follow the rules of the ADA
When it comes to discrimination in general, what employment matters, aside from hiring, are included in antidiscrimination laws?
All employment decisions should be made without discriminatory intent or appearance. This includes wages, termination, advancement, discipline, etc.
Regarding the FMLA; define an eligible part time employee
Someone who works 20 or more calendar weeks in the current or previous year
Who pays FUTA tax; employers, employees or both?
Employers
Among other things, what Act outlines reporting and disclosure obligations, minimum participation rules vesting and funding requirements and fiduciary standards for employees who participate in qualified benefit programs (enforced by Department of Labor)?
ERISA - Employment Retirement Income Security Act
Which of the following is not a required labor law poster?
Consolidated Omnibus budget Reconciliation Act (COBRA)
Fair Labor Standards Act and Minimum Wage
Equal opportunity provisions of the law
The Family and Medical Leave Act
OSHA Job Safety and Health Protection Act
The Employee Polygraph Protection Act
The uniformed Services Employment and Reemployment Rights Act
Right to join/form unions and associations.
Consolidated Omnibus budget Reconciliation Act (COBRA)
Name three of the six potential exceptions the client confidentiality statues.
The client or client’s agent consent to the release
The law requires disclosure
An animal’s health is at stake
A legal dispute has arisen such as malpractice or fee conflict
A board investigation or disciplinary proceeding exists against the veterinarian or animal owner
There is suspected or actual abuse or neglect.
Employees are obligated to maintain client/patient confidentiality even after they have left the employ of the practice.
t/f
True
What entity requires veterinarians to protect the personal privacy of clients and patients and not reveal confidences unless required by law or unless it becomes necessary to protect the health or welfare of other individuals or animals?
The Principles of Veterinary Medical Ethics of the AVMA (PVME)
What is considered a critical statement to include in your Social Media Policy in regards to employees posting confidential photos/videos/text on their personal social media sites?
A statement that any employee conduct, including social media post, that negatively affects the employees job performance, or the performance of team members, clients, patients or distributors, may result in disciplinary action up to and including termination.
According to the Fair Labor Standards Act if a relief veterinarian has a set schedule with your practice but also continues to provide random relief shifts for other practices, are they considered independent contractor?
No (Because of the set schedule)
When it comes to the employment of minors, which age can only work 3 hours per day during school days and 8 hours a day on non-school days? They also cannot begin work prior to 7am
14-15 year olds
____________ occurs when submission to or rejection of unwelcome sexual conduct is used as the basis of employment decisions affecting the individual (apples to protected classes as much as it does gender)
Quid Pro Quo
In most states The Principles of Veterinary Medical Ethics of the AVMA can actually be enforced by law
t/f
False - The AVMA Principles are based more on professional relationships one has with colleagues than moral and ethical issues relating to animals and they cannot be enforced as written
Client confidentiality is a critical part of our profession, with that in mind, when is it considered acceptable for a member of the practice to take client list and information with them when departing?
a. Never
b. When they maintain “relief DVM” relationship with the practice
c. It depends on what the agreement was with the practice
c. It depends on what the agreement was with the practice
Does the VHMA have a Code of Ethics?
Y/N
Yes
What are the 4 Ps of Marketing?
Product, Price, Promotion, Place
What is a reasonable beginning goal for number of transactions per year per doctor?
5000
What Net to New Clients ratio indicates healthy growth of the practice?
6:1
_______________ is a proactive process of gathering data about client preferences and activities to better target their services and products to client needs.
a. Customer Experience Management
b. Customer Relation Management
c. Customer Preservation
b. Customer Relation Management
The goal should be to retain _____%- _____% of clients over a 3 year period.
a. 85%-90%
b. 65%-75%
c. 70%-75%
c. 70%-75%
Each client who presents to the practice should be scheduled for at least one of the 3 follow-up events so that the practice automatically contact each client in the future.
a. Recall, reappointment, reminder
b. Recall, reminder, recheck
c. Reminder, reappointment, referral
a. Recall, reappointment, reminder
Clients retain only ______% of what they hear.
a. 20%
b. 25%
c. 15%
20%
The average person needs to hear about a product or service around _____ times before they purchase it.
a. 10
b. 5
c. 7
5
Clients reference and education materials should always be branded with the mission of the practice.
T/F
False
When it comes to marketing: what is “the key” to increasing compliance and retention?
Communication
Author JD Stowe updated “The Four Ps” of marketing, to what five realistic strategies?
Emotion
Value
Virtue
Excel
Experience
According to JD Stowe, how we tell people, what we promise to give them each and every time they visit our practice is called _____________
Marketing
Social media, open house, community classes and websites are an example of what kind of marketing?
External
What is the percent of revenue budget for retail marketing according to JD Stowe?
1-3%
In regards to knowing your retail pricing advantage; the four basic strategies are Value-added, Unique, Volume and ___________.
Value-based
The sum total of all the ingredients that clients experience as they interact with your practice and your team is called________
Customer Experience
Who is responsible for customer service?
The entire team
___________ is a pro-active process of gathering data about client preferences and activities to better target products and services relevant to their needs.
Customer Relation Management
List the 6 Cs of Client Relationship Management
Consistency
Compassion
Customer Service
Convenience
Competence
Cost
In general, a small animal practice will lose ____% to ____% of their clients every year.
10%-15%
The goal should be to retain ____% to _____% of your clients over a 3 year period.
70-75%
Client acknowledgement, reminders, staff identification, telephone etiquette, professional appearance, clean and pleasant smelling office, and timely replies to client request are all examples of ______________
Internal marketing
List 3 reasons why client education is important
- The person in the exam room may not be the only person who cares for the pet
- Quality client education materials reflect a professional and competent team.
- Written information ensures the same information is being provided to every client, regardless of which doctor or team member is involved in the case, or how hectic the day may be.
- Patient care and compliance is increased
- Giving client’s information in writing and documenting what you gave in the medical record, helps protect the practice from liability in certain situations.
In regards to Client Education, what are the 3 cautions to be aware of?
- Review all materials regularly for necessary updates
- It is better to not give materials out than to give out poor copies or reproduction
- Be aware that different clients will have different learning styles and preferences.
